Provider Demographics
NPI:1184764862
Name:MCGUIRE, MARY JOHANNA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:JOHANNA
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:DMD
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Mailing Address - Street 1:1465 STATE ROUTE 31 S
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3129
Mailing Address - Country:US
Mailing Address - Phone:908-735-6300
Mailing Address - Fax:908-735-6335
Practice Address - Street 1:1465 STATE ROUTE 31 S
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3129
Practice Address - Country:US
Practice Address - Phone:908-735-6300
Practice Address - Fax:908-735-6335
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJDI196231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry